AMBULANCE SERVICE

INTRODUCTION

An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness OR injury and in some instances will also provide out of hospital medical care to the patient.

The word is often associated with road going emergency ambulances which form part of an emergency medical service, administering emergency care to those with acute medical problems.

The term ambulance does, however, extend to a wider range of vehicles other than those with flashing warning lights and sirens. The term also includes a large number of non-urgent ambulances which are for transport of patients without an urgent acute condition.

The term ambulance comes from the Latin word "ambulare" as meaning "to walk or move about which is a reference to early medical care where patients were moved by lifting or wheeling. The word originally meant a moving hospital, which follows an army in its movements.

TYPES OF AMBULANCES Ambulances can be grouped into types depending on whether or not they transport patients, and under what conditions.

Emergency ambulance – The most common type of ambulance, which provide care to patients with an acute illness or injury. These can be road-going vans, boats, helicopters, fixed-wing aircraft (known as air ambulances).

Patient transport ambulance – A vehicle, which has the job of transporting patients to, from or between places of medical treatment, such as hospital or dialysis center, for non-urgent care. These can be vans, buses or other vehicles.

Response unit – Also known as a fly-car or a [Quick Response

Vehicle], which is a vehicle which is used to reach an acutely ill patient quickly, and provide on scene care.

Bariatric ambulance – A special type of patient transport ambulance designed for extremely obese patients equipped with the appropriate tools to move and manage these patients.

Equipment

In addition to the equipment directly used for the treatment of patients, ambulances may be fitted with a range of additional equipment which is used in order to facilitate patient care. This could include

Two-way radio – One of the most important pieces of equipment in modern emergency medical services as it allows for the issuing of jobs to the ambulance, and can allow the crew to pass information back to control or to the hospital.

Trauma lighting – In addition to normal working lighting, ambulances can be fitted with special lighting.

Air conditioning – Ambulances are often fitted with a separate air conditioning system to serve the working area from that which serves the cab. This helps to maintain an appropriate temperature for any patients being treated, but may also feature additional features such as filtering against airborne pathogens.

Data Recorders – These are often placed in ambulances to record such information as speed, braking power and time, activation of active emergency warnings such as lights and sirens, as well as seat belt usage.

Active visual warnings

The active visual warnings are usually in the form of flashing lights. These flash in order

to attract the attention of other road users as the ambulance approaches, or to provide

warning to motorists approaching a stopped ambulance in a dangerous position on the

road. Common colors for ambulance warning beacons are blue, red, amber, and white

(clear).

Audible warnings

In addition to visual warnings, ambulances can be fitted with audible warnings, sometimes known as sirens, which can alert people and vehicles to the presence of an ambulance before they can be seen.

Service providers

Government Ambulance Service – Operating separately from (although alongside) the

fire and police service of the area, these ambulances are funded by local or national

government.

Volunteer Ambulance Service – Charities or non-profit companies operate ambulances,

both in an emergency and patient transport function.

Private Ambulance Service – Normal commercial companies with paid employees, but

often on contract to the local or national government. Private companies may provide only

the patient transport elements of ambulance care.

Charity Ambulance – This special type of ambulance is provided by a charity for the purpose of taking sick children or adults on other hospital .

Cardiac Ambulance

Cardiac Ambulance provides a network of Fully Equipped Life Support Ambulances in the

city of Mumbai. In case of a medical emergency, any Mumbai resident may accessing a fully

equipped Advanced Life Support Ambulance within the shortest possible time. Ambulances

are located in strategic locations. After recieving the call in the shortest possible time, the

nearest free Ambulance will reach at your place to rescue the patient / victim.

Cardiac Ambulances are equipped with international quality instruments for international

standards of service & care. The Emergency physicianon board are trained usually working

in the city ICU's and Emergency department and are adequately experienced to handle all

kinds of Emergencies.

Cardiac ambulance contains:-

Doctor Trained Nurse

E. C. G. Cardiac Monitor

Defibrillator Portable Ventilator

Suction machine Pulse Oxymeter

Oxygen Emergency Medicines

Resuscitation kit Nebuliser

Syringe Pump Bipap

Pace Maker Spine Board

The Ambulance has air-conditioning, mild sound proofing and silicon sealing in joints. It also has on board a collapsible trolley stretcher and a stair chair. The Ambulance crew usually consists of a physician, nurse, driver and a helper. Cardiac Ambulance are available for transferring the patients all over India.

108 Emergency Service

How it works:-

When an emergency is reported through 108, the call taker gathers the needed basic

information and dispatches appropriate services. Basic information obtained includes:-

Where the call is placed from. ( district / taluka /city / town / exact location / landmark)

The type of emergency.

Number of people injured and the condition of the injured.

The caller's name and contact number – for location guidance if required.

Emergency help dispatched through this process is expected to reach the site of the

emergency in an average of 18 minutes. Pre-hospital care will be given to patients being

transported to the nearest hospital. The service is normally free to patients .

108 is managed by the EMRI ( Emergency Management and Research

Institute) across more than ten states in India.

During an emergency situation, knowing what to do might save someone’s life. Here

are a few tips on what you should tell the emergency dispatcher while calling for an

ambulance:

1. Be calm and tell the emergency operator the details about the type of emergency 2. You will be asked to tell him/her the address to where the ambulance should

reach, including postal code. 3. Your phone number may also be asked for, in case the operator needs to contact

you for directions. 4. He/she will also require the patient’s age, sex and any medical history you might

remember. 5. The operator will also need to know if the person is bleeding, if he/she is

conscious, has chest pain and is breathing. 6. You will also be asked to explain the type of injury or emergency and what caused

the incident.

AMBULANCE SERVICES IN R.N. COOPER HOSPITAL

The Cooper Hospital is a public hospital located in Juhu, Mumbai, India. It is owned by the

Brihanmumbai Municipal Corporation and is operated under a public-private partnership.

It was started in 1969 as a maternity home before it was converted into a full fledged general

hospital in 1970.

The hospital underwent massive reconstruction after the original building was declared unfit for

use in 1999. The new upgrade, at a cost of ₹321 crore, includes more beds, as well as systems for

rainwater harvesting and sewerage treatment.[1] The new hospital design includes an infection

control design to prevent doctors from contracting tuberculosis while on duty.

A medical college has been planned at the hospital by the BMC. Since the hospital does not have the

required 800 bed strength, it has been proposed to jointly run it at Cooper as well as the Bal

Thakeray Trauma Care Hospital in Jogeshwari.

There are only 2 BMC ambulance in R.N. copper

hospital24/7.

Early there was 4 ambulance but right now there is only 2

ambualnce and one 108 ambulance is there.

1. Basic Life Support (BLS) Ambulance

2. Advanced Life Support (ALS) Ambulance also called as

Cardiac Care Ambulance

Basic Life Support (BLS) Ambulance

A basic life support ambulance is equipped with life support equipment like an oxygen cylinder, BP monitor and stethoscope. This type of ambulance can be used for emergencies when the patient can be transported to the hospital quickly. Advanced Life Support (ALS) Ambulance

This ambulance is fitted with advance life support machines such as defibrillators (a machine used to restart the heart), ECG machine (used to keep a check on the heart rate of a person), Ventilators, Oxygen cylinders, Pulseoxymeter(used to check for the mount of oxygen in the blood) , Resuscitation kit, suction machine, Nebuliser and BP apparatus. This kind of ambulance can be used in cases where the patient is either unconscious, has had a heart attack or is a known patient of heart disease. It can also be used in cases the patient has to be transferred to a hospital that is far away, or he/she is immobile and on life support.

Extentionno.:-116

It is free of cost service for patients means

the hospital not charging a single rupees

for transportation.

If patients have to shifted in any other

government hospital in Mumbai it is free

of cost service for them.

If patients have to shifted in any private

hospital then ambulance service is not

applicable for them.

Than The patients relatives have to

arrange private ambulance service and

have to pay the decided charges.

Process of arranging ambulance for

patients in cooper hospital:-

If patient is admitted in ward or in

casualty and he/she have to shifted in

other government hospital than the

respected Dr. given in written that the

patients have to shifted in respected

hospital to the medical officer or to the

r.m.o.

Than r.m.o. call to the service department

and arrange the required ambulance.

After that the shift the patient in respected

hospital.

If the oxygen cylinder is not working in the

BLS ambulance then they take oxygen

cylinder form wards.

There is one 108 emergency cardiac

ambulance in cooper hospital. Which is a the araea ambulance.

If there is no ambulance available at the

time of emergency than the hospital again call

the 108 and they provide the another cardiac

ambulance.

Ambulance reach at the site within 10 to 15 min.

MANPOWER/STAFFS

STAFF MORNING SHIFT

7.AM TO 3.PM AFTERNOON SHIFT

3.PM TO 11.PM NIGHT SHIFT

11.PM TO 7.AM

DRIVER =06

02 02 02

ATTENDENT =3 TO 4

01 01 02

DOCTOR AND NURSES it is dependent upon

the patient’s condition.

If patient’s condition is more critical then

three is 1 doctor and 2 staff nurse.

Generally there is one Dr. and one nurse

should be there in the ambulance with

patients till the patient is shifted to another

hospital.

The no. of Attendants is also dependent upon

the patient’s condition.

All the audio visuals (sirens) are working properly.

Record maintainance

In cooper hospital they are maintaining the

records of ambulance services provided to the

patients for translocation in the other

municipal hospital.

It is free service for patients.

The record book

In cooper hospital the driver and attendant

are using mobile phone for conversation with

hospital department about the current status

of ambulance means where it reaches.

DATE

PATIENTS NAME

WARD/REGI NO. OF PTS

VAN NO.

OUT TIME

INTIME DESTINATION

FREE AMBUALCE

TYPE

SIGN

12-04-16

SOMUBAI JADAV

GYN/0258 MHO258

10.30 AM

12.45 PM

KEM - BLS

-

Repairing of mechanical parts of

ambulance/ servicing

If any problem occurs in ambulance

then they send the ambulance for

servicing and repairing in the garage.

There is a municipal garage in Bandar

east where they send the ambulance

for servicing and repairing.

It is free service for cooper hospital

means they are not charging money for

servicing of ambulance.

They get the funds from government.

PROBLEMS in AMBULANCE SERVICE OF R.N.

COOPER HOSPITAL

1. The hospital should increase the no. of

ambulance.

2. There is no machine/equipment properly

working in Cardiac Ambulance.

3. If any patient is in sever condition then they

call/use 108 emergency ambulance service.

4. Because it is easily available that’s why the

hospital n not increasing the no. of ambulance.

5. The payment of Driver and attendant is not

paid on time.